November 2010

Analysts in the North Carolina workers’ compensation and unemployment benefits community are anxiously awaiting November 30th. On that day, the U.S. Congress is set to either potentially extend federal funds for unemployment benefits… or not.

If Congress fails to extend the federal funds, states like North Carolina would have to make up the difference. In North Carolina, according to experts in the Employment Security Commission, this would mean that the 300,000+ residents who collect unemployment would have to turn to the state for help. North Carolina collected $2.35 billion from the federal government this year to support the state’s unemployment fund. Over the past 12 months, $5.4 billion in state and federal benefits have been paid out to NC residents.

In a healthy economy, unemployment compensation extends for 26 weeks. Fueled by fears over economic crises, however, legislators opted to extend the benefits period to 99 weeks temporarily. Progressive advocates, like Alexander Sirota of the North Carolina Budget and Tax Center, worry that a federal cut off of funds could spell trouble for the regional economy.

When individuals lose access to North Carolina workers’ compensation or unemployment benefits, they suddenly don’t have money to reinvest in local economies. This cash flow shortage theoretically could precipitate broader economic problems.

Furthering complicating matters… the state remains mired in dire economic straits. October statistics showed NC unemployment hovering just under 10%. NC has already weathered several months of double-digit unemployment since the start of the “Great Recession.”

Are you or a family member struggling with how to make ends meet during these tough times? If so, you may need help meeting your challenges head-on. For instance, perhaps you are juggling multiple issues at once. Maybe an insurance company has challenged the validity of your injury claim. Or maybe an employer has suddenly refused to pay out your full benefit amount, citing internal financial difficulties.

To compel the system to work fairly for you, consult with an experienced North Carolina workers’ compensation firm. A strong legal strategy can ensure that you maximize your benefits and prime yourself to take best advantage of any new job opportunities that present themselves to you.

While most North Carolina workers’ compensation analysts probe the local news for instructive stories, sometimes blogs look to international sources to find the most compelling news. And a case out of Toronto – reported by the Vancouver Sun – has many in the North Carolina workers’ compensation community talking. An Alberta tribunal has ordered workers’ comp payments for a convenient store worker who suffered serious shoulder injuries from scooping hard ice cream. According to the Sun’s report, the woman had to serve up an enormous quantity of orders in a short period of time during a heat spell in April 2009. The Appeal Board noted that “the activity required considerable force with her right hand and arm in a twisting motion because the ice cream was frozen hard…the total sale of ice cream cones [for a 2 day period] was $1,500.”

The woman had been treated for a shoulder injury prior to working at the ice cream store and had rectified that injury through the use of cortisone shots. But the ice cream scooping reinjured her shoulder so badly that she needed surgery on her rotator cuff to deal with the flare up. The Sun’s article quoted an orthopedic surgeon, Dr. Stephen Reed, who argued that ice cream scooping is indeed a dangerous activity. Dr. Reed said “they are forced to do this basically at arm’s length, reaching into a large cabinet…it’s basically poor ergonomics, and they are doing it repetitively.”

Repetitive strain injuries due to manual labor, such as ice cream scooping, typing, or repetitive lifting, can cause lasting damage to muscles, fascia, ligaments, and other soft tissue. More frustratingly, the full extent of the damage may take weeks or months to reveal itself. By the time an injured employee notices what’s been happening, it may be too late to reverse the problems easily.

If you or someone you love or work with has been sidelined with a repetitive stress injury or other workplace injury, either chronic or acute, you can benefit tremendously from consulting with a qualified North Carolina workers’ compensation firm. By exploring your rights as a potential claimant, you can collect compensation for things like your lost wages and medical bills. Moreover, you can simplify the process, focus your limited resources on healing from your injuries and getting back to work (or finding new work), and holding reluctant employers or insurance companies fully accountable.

Last month, the North Carolina Court of Appeals upheld a decision in the North Carolina workers’ compensation case of Cardwell v. Jenkins Cleaner, Inc. The claimant slipped and fell on a stretch of black ice in the parking lot adjacent to her workplace (Jenkins Cleaner) and broke her wrist. She argued that, since she fell near the back door of her workplace, she should get workers’ comp. But the North Carolina Court of Appeals said that her broken wrist was not compensable because the parking lot in which she fell was not owned by her employer. In fact, her employer shared that lot with several other businesses. One judge dissented, saying that, since the entrance door to the cleaner’s was “in such proximity in relation” to the parking lot, the area where she slipped was “in practical effect on the employer’s premises.”

In general, a worker who gets hurt while on an employer’s property can get North Carolina workers’ compensation benefits. But as this case illustrates, subtle nuances and complexities can make the process complicated, if not impossible, for claimants.

Many potential claimants don’t understand their rights and/or don’t seek legal benefits in situations where a claim might be justified. For instance, a pizza delivery worker who gets hurt while driving to a delivery can get workers’ comp from his employer, even if the driver was far away from the restaurant when the traffic accident occurred. Many cases hinge on minor, seemingly irrelevant details. In this case, for instance, at issue was whether Cardwell’s fall happened on the employer’s premises or on a property that the employer did not control. Since she slipped in sort of a “grey zone,” the Court of Appeals ended up delivering a divided decision.

All this is to say that, if you or someone you care about has been dealing with a complicated claims issue, you should avail yourself of the most potent resources to defend your benefits. An experienced North Carolina workers’ compensation firm can provide a free case evaluation and advise you about the most efficient and practical steps to take to guarantee your claim and eliminate resistance from uncooperative employers or bad faith insurers.

A November 18th article in Wall Street Journal about the profitability of workers’ comp insurance has carriers who deal with North Carolina workers’ compensation policies buzzing. Liberty Mutual’s Chief Executive Officer was quoted in the article worrying about the threat of inflation to the workers’ comp industry. Edmund “Ted” Kelly hinted that his company would “willingly reduce our exposure” to the workers’ comp sector because of fears of inflation.

Across the industry – including here in North Carolina — workers’ comp coverage is sold at a loss. This means that insurers pay out more in claims than they collect through premiums. This isn’t to say that insurers don’t make money in this business. They take the premium money they collect and invest it to generate profit. But the CEO worries that the “time bomb” may soon go off – perhaps as early as 2014 – and cause serious tremors throughout the industry.

What might this all mean for employers and claimants here in North Carolina? It’s obviously too early to even begin to speculate how industry-wide policies could come back to alter employer practices or employee resources. But it’s important to recognize that there is a relationship here. Often, when employers and employees complain about the “unfairness” of this system, they are ultimately frustrated by macro level decisions made by the insurance industry or made by policy makers in Washington or in the NC state capital. Obviously, if you suffer from a lower back injury from work you did at a construction site in Raleigh, you don’t need to follow the latest AIG sales strategies. But the people who represent you with your claim should demonstrate a deep awareness of what’s going on in the industry – at both the state and national levels.

After all, North Carolina workers’ compensation claims can often get incredibly complicated and convoluted, even if they start out seeming simple. An employer may do a 180, for instance, and refuse to pay out a legitimate claim. Or an insurer may deny a claim based on bad data or an obscure provision written into a contract somewhere. Injured workers obviously don’t have the time, energy, or wherewithal to delve into all these legal details, and they often find the system to be tremendously inflexible and unresponsive. These people need advocates who can help make the system work for them – and most importantly, to make things simpler, easier, and faster, so that they can focus on healing, being with their families, plotting out their financial strategies, and getting back to work.

A North Carolina workers’ compensation firm can provide you with the strategic know-how and guidance you need to manage your claim productively and eliminate the enduring stresses associated with it.

When policy analysts, insurance companies, employers, and employees come together to work on problems with the North Carolina workers’ compensation system, they inevitably look at things like cost control, red tape cutting, and the elimination of fraud. But the experts often overlook global solutions that could yield profound good for every entity in the system. This essay takes a look at some mechanisms that employers and employees can institute at their workplaces to boost productivity and efficiency without making employees work harder or longer.

A 19th Century economist named Pareto made the observation that 80% of systems often divide according to a kind of 80/20 principle. 20% of people in a population will own 80% of the population’s wealth, for instance. Similarly, 20% of the activities that you do at work will generate 80% of your profits. And so on. A careful deployment of the 80/20 rule in your office can eliminate time wasting and potentially dangerous repetitive activities and replace them with productive activities that generate more profit and create less of a strain on workers.

2. Parkinson’s Law

As author Tim Ferriss points out in his book, The 4-Hour Workweek, “Parkinson’s Law” is an excellent companion to the 80/20 rule. What this law states basically is that a task will fill up the amount of time allotted for it. So if you ask an employee to do a report in six hours, he will finish that report in six hours. If you ask him to do it in two hours, he will finish it in two hours. And the difference in quality between those two results will actually be surprisingly quite negligible. This may be counterintuitive, but Parkinson’s Law does bear out in many different cases, at least anecdotally. So you could use this principle to streamline machining processes, prevent workers from typing too much, and limiting the amount of hours and energy you put into dangerous activities, such as scaffolding work on a construction site (for instance).

3. Get People Talking

The best solutions to workplace dangers often come from the people closest to the problems. Corporate management in the United States – and in North Carolina – tends to work on a top down level. In other words, the CEOs and other high executives dictate terms to the people lower on the food chain. But this kind of practice leads companies to turn a blind eye to persistent ground level problems. If these problems could be solved, not only would the company benefit, but the employees would also get more control over their activities and hours and enjoy their work more – and be less at risk for workplace injuries.

If you’ve been hurt at work – or if one of your co-workers needs help – you should look to a qualified North Carolina workers’ compensation law firm to discuss strategies and tactics to get benefits in a timely fashion.

Developing an efficient and resourceful response to your workers’ comp problems is almost certainly doable, and the faster you get good guidance, the faster you will be able to resolve the stress associated with your injury and recovery and move on with your life.

Whether you’ve been on and off North Carolina workers’ compensation for a bad back or other occupational injury for years; or you are concerned about chronic nagging aches and pains, you want solid and tested advice about how to take better care of your back.

When most people think about back injuries, they envision things like falling off a crane at a construction site, slipping and falling on a patch of dry ice in the office parking lot, screwing up one’s lower back while trying to pick up a heavy box, or getting whiplash in an auto accident.

While all these situations can result in back injuries, chronic abuse of muscles and poor posture can also cause/exacerbate back problems. For instance, if you work a desk job, and you don’t employ proper ergonomic techniques and tools, over time, your posture can degrade, making you more vulnerable to muscular weakness, atrophy, and damage to soft tissue. This can actually weaken your structure to the point that a back injury may be almost inevitable.

Furthermore, your diet can influence your potential to get hurt (or to recover from) a back injury. If you consume lot of heavily processed foods and sugars, you can weaken your immune system and degrade your body’s natural resilience to things like stress.

Obviously, this blog cannot provide medical advice, but if you or someone else that you love has been dealing with a North Carolina workers’ compensation claim for your back, you might want to explore modalities with your physical therapist and physician to strengthen your body and eliminate the factors in your life and workplace that may be causing or exacerbating back problems. For instance, cutting out refined sugars and starches can help the body’s immune system. Engaging in regular strength training overseen by a therapist can be useful for many people, even for workers in “non-active jobs,” such as data entry or marketing. De-stressing can also be a crucial resource, as can taking regular breaks from repetitive activity.

Other more “exotic” forms of back strain relief include the Alexander Technique, Sarno body awareness, and Feldenkrais movement. For certain individuals who have been severely or chronically injured, traditional therapies, like surgery, may be needed. Other modalities that some have found useful to treat back pain include massage, acupressure, acupuncture, and training in meditation/mindfulness.

On a more general note… many injured workers develop a mentality of helplessness. Since they’ve been hurt, and they have suffered financially, they feel a loss of control over their lives. Fortunately, this loss of control is often imaginary. Even if you have sustained serious problems, you can take advantage of good modalities to speed up healing and prevent re-injury.

All that said, from a practical “nuts and bolts” point of view, you still likely have many questions about how to collect benefits owed to you, how to navigate the workers’ comp system, how to deal with bad faith insurers, and how to manage less than cooperative employers. For help now, turn to a capable and experienced North Carolina workers’ compensation law firm.

A heated battle between a company called Majestic Capital Limited and the New York State Workers’ comp board has finally burned its way out, according to North Carolina workers’ compensation analysts and major news organizations.

Per the terms of the big settlement, Majestic Capital will pay $41 million to the State of New York, pursuant to allegations that the company mismanaged a number of trusts, indirectly causing damages equaling around $400 million. Attorney General Andrew Cuomo (who was elected Governor of New York on Tuesday November 2nd) oversaw the settlement with Majestic.

The details are quite complicated and convoluted. Majestic is incorporated in Bermuda, but the company has its headquarters in Poughkeepsie. The California Department of Insurance, Bermuda Monetary Authority, and an independent errors and omissions insurance carrier all played key roles in paying for and/or negotiating the terms of the settlement and the logistics of the arrangement.

North Carolina workers’ compensation experts can look at cases like this and probe them to understand the minutiae. But individual claimants, who are dealing with issues like sore backs, on the job slip-and-fall injuries, and asthma from inhaling polluted air at work, may have little to no interest in these nuances. The reason why we want to mention this $41 million settlement is to illustrate how convoluted workers’ compensation law can become.

Sure, this case was a relatively big one. But look how complicated it got. It ended up involving entities in California, Bermuda, New York, and elsewhere. Who knows how many dozens of people had to hammer out solutions and hash out the logistical details.

All of this is to say that, if you are struggling to come to terms with an insurance related question, or if you want to compel your boss to take your claim more seriously, it may behoove you to work with experts who understand the system.

A competent, experienced, and resource rich North Carolina workers’ compensation law firm can give you an upfront consultation and help you understand how to proceed most efficiently and effectively.

On November 2, Washington state voters soundly rejected Initiative Measure 1082, which would have privatized WA’s workers’ comp system. North Carolina workers’ compensation experts, as well as other industry-watchers from around the nation, reacted with surprise at the trouncing that the Measure took. 58% of state voters said No to Measure 1082, which would have eliminated Washington’s fairly unique system, in which the State’s Department of Labor and Industries owns a monopoly on workers’ comp insurance. The Building Industry Association of Washington backed 1082; trial lawyers groups and labor unions opposed it. According to a member of the “No on 1082” campaign, “We told people to read the fine print, and in the fine print of 1082, they will see it has huge cost for small businesses.” Representatives for the Association of Washington Businesses disagreed and insinuated that voters had allowed the sloganeering of the “No on 1082” crowd to sway opinions.

Had 1082 passed, private insurers would have been allowed to sell policies, and workers would no longer have had to pay part of their workers’ comp premiums.

The North Carolina workers’ compensation system is structurally very different from the Washington system. But if you are a claimant who is having a problem with an insurer or an employer, you probably don’t care too much about the politics or philosophy. Instead, you want clear and simple answers to burning questions about workers’ comp practices and protocol.

To stay on track with your claim, keep focused on what you want out of your benefits. More importantly, focus on your long-term game plan – financially, work-wise, and otherwise. Aim not just to collect the benefits owed to you but also to protect your family’s rights and financial future. If you’ve been struggling with a difficult issue regarding your benefits, consult with a well regarded North Carolina workers’ compensation firm at your earliest convenience to eliminate hassle and generate best results.

North Carolina workers’ compensation experts along with media analysts across the country are all talking about a momentous sentencing decision out of California. A Laguna Hills man convicted of perpetrating the biggest California workers’ comp premium fraud in history has been sentenced to a decade in state prison.

51-year-old Michael Vincent Petronella was ordered by the court to pay $500,000 in restitution to the CA State Compensation Insurance Fund on top of fines of equaling $550,000. In February, Petronella was found guilty of an unbelievable 33 felony counts of insurance fraud. According to an AP report, Petronella and his wife “fraudulently submitted 42 claims for uninsured workers and unreported $29 million in pay roll to avoid paying insurance premiums.” As a result of their scheme, the state lost millions in insurance premiums and over $250,000 in uncovered worker claims. At the same time, Petronella and his wife apparently lived a life of opulence. They owned 2 Ferraris, jewelry worth hundreds of thousands of dollars, and closets upon closets of apparel from luxury designers like Burberry, Chanel, and Gucci.

Petronella’s ex employees and the local Deputy District Attorney complained that the judge did not order even more forced restitution. The Deputy DA, who had asked that Petronella pay $35 million to California, said that “the court’s ruling establishes that it pays to commit fraud.” The DA wanted Petronella to spend 37 years in jail. She expressed contempt for the judge’s decisio: “[Petronella] has taken no responsibility for his conduct… when he gets out, he will do it again.”

North Carolina workers’ compensation policymakers pay attention to out of state fraud cases to understand potential industry-wide implications. Since this case against the Laguna Hills roofer may be the biggest in California’s history, the decision could indirectly inform future debates over the correct punishment for workers’ comp fraud.

Pulling back from the abstract, for a second, what might this case tell us about the rights and responsibilities of individual claimants? The biggest takeaway is that a claimant needs to be mindful of adhering closely to the rules. Even if you don’t “intend” to cheat the system, you can still be flagged for problems with your claim if, for instance, you shortcut your paperwork or miss a deadline.

If you’ve been dealing with issues regarding your claim, consult with a reputable and highly credentialed North Carolina workers’ compensation firm to strategize about the most efficient ways to eliminate the constraints on your benefits.